@article{ref1,
title="Zero suicide implementation-effectiveness trial study protocol in outpatient behavioral health using the A-I-M suicide prevention model",
journal="Contemporary clinical trials",
year="2020",
author="Stanley, Barbara and Labouliere, Christa D. and Brown, Gregory K. and Green, Kelly L. and Galfalvy, Anga C. and Finnerty, Molly T. and Vasan, Prabu and Cummings, Anni Kramer and Wainberg, Milton and Carruthers, Jay W. and Dixon, Lisa B.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: The treatment of suicidal patients often suffers owing to a lack of integrated care and standardized approaches for identifying and reducing risk. The National Strategy for Suicide Prevention endorsed the Zero Suicide (ZS) model, a multi-component, system-wide approach to identify, engage and treat suicidal patients. The ZS model is a framework for suicide prevention in healthcare systems with the aspirational goal of eliminating suicide in healthcare. While the approach is widely endorsed, it has yet to be evaluated in a systematic manner. This trial evaluates two ZS implementation strategies statewide in specialty mental health clinics.   METHODS/STUDY DESIGN: This trial is the first large-scale implementation of the ZS model in mental health clinics using the Assess, Intervene, and Monitor for Suicide Prevention (A-I-M) clinical model. Using a hybrid effectiveness-implementation type 1 design, we are testing the effectiveness of ZS implementation in 186 mental health clinics in 95 agencies in New York State. Agencies are randomly assigned to either: &quot;Basic Implementation&quot; (BI; a large group didactic learning collaboratives) or &quot;Enhanced Implementation&quot; (EI; participatory small group learning collaboratives; enhanced consultation for site champions). Primary outcomes include suicidal behaviors, hospitalizations and Emergency Department visits; implementation outcomes include protocol adoption, protocol fidelity and barriers/facilitators to implementation.   DISCUSSION: This project has the potential to have a significant public health impact by determining the effectiveness of the ZS model in mental health clinics, a setting where suicide attempts and suicides occur at a higher rate than any other healthcare setting. It will also provide guidance on the implementation level required to achieve uptake and sustainability of ZS.   TRIAL REGISTRATION: N/A.<p /> <p>Language: en</p>",
language="en",
issn="1551-7144",
doi="10.1016/j.cct.2020.106224",
url="http://dx.doi.org/10.1016/j.cct.2020.106224"
}